{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:46:24Z","timestamp":1785422784200,"version":"3.56.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Object:<\/jats:bold> The benefits of low-dose esketamine for painless gastrointestinal endoscopy remain unclear. As such, the present study aimed to investigate the efficacy and safety of low-dose esketamine for this procedure.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Seven common databases were searched for clinical studies investigating low-dose esketamine for painless gastrointestinal endoscopy. Subsequently, a meta-analysis was performed to synthesize and analyze the data extracted from studies fulfilling the inclusion criteria.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Meta-analysis revealed that, compared with propofol, low-dose esketamine in combination with propofol significantly reduced recovery time by 0.56\u00a0min (mean difference [MD] \u22120.56%, 95% confidence interval (CI) \u22121.08 to \u22120.05, <jats:italic>p<\/jats:italic> = 0.03), induction time by 9.84\u00a0s (MD \u22129.84, 95% CI \u221212.93 to \u22126.75, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001), propofol dosage by 51.05\u00a0mg (MD \u221251.05, 95% CI \u221281.53 to \u221220.57, <jats:italic>p<\/jats:italic> = 0.01), and increased mean arterial pressure by 6.23\u00a0mmHg (MD 6.23, 95% CI 1.37 to 11.08, <jats:italic>p<\/jats:italic> = 0.01). Meanwhile, low-dose esketamine reduced injection pain by 63% (relative risk [RR] 0.37, 95% CI 0.28 to 0.49, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001), involuntary movements by 40% (RR 0.60, 95% Cl 0.42 to 0.85, <jats:italic>p<\/jats:italic> &amp;lt; 0.005), choking by 42% (RR 0.58, 95% Cl 0.38 to 0.88, <jats:italic>p<\/jats:italic> = 0.01), bradycardia by 68% (RR 0.32, 95% Cl 0.18 to 0.58, <jats:italic>p<\/jats:italic> = 0.0002), hypotension by 71% (RR 0.29, 95% Cl 0.21 to 0.40, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001), respiratory depression by 63% (RR 0.37, 95% 0.26 to 0.51, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001), additional cases of propofol by 53% (RR 0.47, 95% Cl 0.29 to 0.77, <jats:italic>p<\/jats:italic> = 0.002), and increased hypertension by 1000% (RR 11.00, 95% Cl 1.45 to 83.28, <jats:italic>p<\/jats:italic> = 0.02). There were no significant differences in mean heart rate, mean oximetry saturation, delirium, dizziness, vomiting, tachycardia, and hypoxemia. Subgroup analyses revealed that, compared with other dose groups, 0.25\u00a0mg\/kg esketamine afforded additional benefits in recovery and induction time, mean arterial pressure, involuntary movements, hypoxemia, and respiratory depression.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Low-dose esketamine was found to be safe and effective for providing anesthesia during gastrointestinal endoscopy, with 0.25\u00a0mg\/kg identified as the optimal dose within the dosage ranges examined. However, caution should be exercised when administering this drug to patients with inadequate preoperative blood pressure control.<\/jats:p>","DOI":"10.3389\/fphar.2024.1364546","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T04:55:38Z","timestamp":1712292938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy and safety of low-dose esketamine for painless gastrointestinal endoscopy in adults: a systematic evaluation and meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Juan","family":"Deng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Feng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Guo","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua-Juan","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan-Chuan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"789","DOI":"10.2174\/138945005774574533","article-title":"Ketamine: new indications for an old drug","volume":"6","author":"Annetta","year":"2005","journal-title":"Curr. 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